Provider Demographics
NPI:1962619155
Name:PATLEN, DONALD J JR (DMD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:PATLEN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:1 SUSSEX STA STE 104
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461-2215
Mailing Address - Country:US
Mailing Address - Phone:973-875-9911
Mailing Address - Fax:973-875-4147
Practice Address - Street 1:1 SUSSEX STA STE 104
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:NJ
Practice Address - Zip Code:07461-2215
Practice Address - Country:US
Practice Address - Phone:973-875-9911
Practice Address - Fax:973-875-4147
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice